This invention relates in general to the cleaning of health care instruments prior to sterilization, and is especially useful in cleaning sharp ended cutting and probing medical and dental instruments which are employed in the course of health care delivery services.
During routine procedures performed on patients, reusable health care instruments may accumulate organic and inorganic debris that must be removed prior to sterilization as is necessary before such instruments are reusable for their intended purpose.
Common disinfection and sterilization procedures are often not capable of removing solids that may have accumulated on the instruments during use.
For example, blood has long been recognized as a potential source of pathogenic microorganisms that may present a risk to individuals who are exposed during the performance of their duties. In 1983 the CDC published guidelines for controlling infections in hospitals. One section, entitled "Blood and Body Fluid Precautions," recommended that certain precautions be taken in handling the blood and body fluids of patients who were known infected, or were suspected of being infected, with bloodborne pathogens. Special precautions were recommended to be followed with such patients.
Most sterilization procedures employ soaking and extreme heating but not friction to dislodge and remove accumulated solids.
The most universally accepted and time-tested procedure to remove solids has customarily been to use a hand-held bristle brush such as a nylon bristle nail brush or a tooth brush. The technician holds an instrument in one hand and strikes and/or brushes the instrument with a bristled brush wielded by the other hand.
More recently, ultrasonic cleaning has also been used compared to hand-held brushing. This procedure is viewed at least as an additional method of cleaning and some authorities contend it is superior to hand scrubbing. Ultrasonic cleaning does, however, require machinery, expensive maintenance and considerable expenditure of time in its practice. Ultrasonic cleaning will not, in all cases, remove dried and hardened matter adhering to an instrument. A preponderance of authorities agree that ultrasonic cleaning is most effective when used in conjunction with hand brushing.
Hand-held, reusable instruments utilized in health care delivery, and especially in dentistry, often have a working end at each end of the instrument that can be pointed and/or cutting blade sharp. The design of these instruments permits probing and cutting of hard and soft tissue in the mouth and shaping and carving of dental restorative materials. The functional ends of these instruments present serious risk of cuts and puncture to the technician cleaning them and especially while the technician is attempting to remove accumulated solids from the instruments by use of a hand-held bristle brush. Debris accumulated on the contaminated instruments contains n microorganisms that can infect the technician. These microorganisms may include hepatitis, HIV, and a myriad of other infectious diseases that pose a serious health risk to the technician handling a soiled instrument.
There does not appear to be any adequate scrubbing device presently available to health care providers that permits hand-held reusable instruments to be cleaned manually, and without risk of infection to the technician from a contaminated instrument in the event of a cut or puncture would from that instrument or from aerosolized contaminated cleaning liquid that may escape into the environment.